Wednesday, January 13, 2010

The new and improved versions of Cognitive Behavioral Therapy (CBT) are Transdiagnostic CBT and Dialectical Behavior Therapy (DBT). Until recently, Cognitive Behavioral Therapy (CBT) has been considered the most effective treatment in helping binge eaters overcome their eating disorders.

According to the Mayo Clinic, CBT is “…a type of talk therapy…[CBT] helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones….based on the idea that your own thoughts — not other people or situations — determine how you behave.”

A study of Transdiagnostic CBT was published in The American Journal of Psychiatry in 2008 and was conducted by Christopher G. Fairburn, D.M., F. Med. Sci. and his colleagues. The study states, “Despite its [EDNOS] prevalence, there have been no studies of the treatment of ‘eating disorder not otherwise specified (EDNOS).’” This is unbelievable that there have been absolutely NO studies that include EDNOS: binge eating falls into this category as I reported in my last piece. So now we’re getting somewhere.

In the study, two different types of CBT were administered to adult outpatients. In fact, Psychotherapybrownbag.com’s Joye C Anestis, M. S., looked into this study and explains the two types of CBT. One was, she writes “a form [of CBT] which focuses exclusively on the eating disorder and [the other] a broad form which addresses….self-esteem, perfectionism, interpersonal problems and mood intolerance.”

The doctors determined that “both Transdiagnostic treatments appear to be suitable for the majority of out-patients with an eating disorder.” More study needs to be done, but that binge eating patients were included for the first time in a trial is a start. That should have happened long ago.

Moreover, the other form of CBT, Dialectical Behavior Therapy, Michael D Anestis, M.S. also of psychotherapybrownbag.com claims, “Is the most fulfilling approach to therapy in which I have been trained. I cherish the experiences I’ve had co-leading skills groups.”

A study just published in “Eating Disorders: The Journal of Treatment and Prevention” Michael Anestis explained that “…protocol was referred to as DBT-informed.” It consisted of, “twice weekly DBT skills training… weekly group sessions involving motivation and commitment, goal setting, and behavioral chain analysis….daily diary cards…weekly yoga and a ‘DBT-in-action’ group that promoted the practice of DBT skills…. taught clients healthy eating practices.”

DBT skills include mindfulness training. I could use more practice being mindful and calm and many of the other skills taught in this trial.

Again, Michael Anestis concluded that “Although more research on the use of DBT in eating disorders in general and BN and BED in particular is necessary, all of the research to date supports this approach as an efficacious treatment.”